CaliforniaProvider directory disclosures.
What it does
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires specified health care service plans and health insurers to publish and maintain a provider directory or directories with information on contracting providers that deliver health care services to enrollees or insureds, and requires a health care service plan or health insurer to regularly update its printed and online provider directory or directories, as specified.
More detail
Existing law requires provider directories to include specified information and disclosures.
This bill would require a full service health care service plan, specialized mental health or dental plan, health insurer, or specialized mental health or dental insurer to include in its provider directory or directories a statement advising an enrollee or insured to contact the plan or insurer for assistance finding an in-network provider and for an explanation of their rights regarding out-of-network coverage, and would specify the format of the statement. The bill would require the plan or insurer to acknowledge the request within one business day if contacted for that assistance, and to provide a list of in-network providers confirmed to be accepting new patients within 2 business days for a request deemed urgent by the enrollee or insured and 5 business days for a request deemed nonurgent by an enrollee or insured. Because a violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Where do you stand?
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Where it stands
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2025
- Aug 29In committee: Held under submission.Latest
- Jul 7In committee: Referred to APPR. suspense file.Minor
- Vote recorded Placed on suspense file. Result: pass.Upper
- Jun 23Read second time and amended. Re-referred to Com. on APPR.Major
- Jun 19From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (June 18).Major
- Jun 18
- Vote recorded Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]. Result: pass.Upper
- May 14Referred to Com. on HEALTH.Minor
- May 6In Senate. Read first time. To Com. on RLS. for assignment.Minor
- May 5Read third time. Passed. Ordered to the Senate. (Ayes 77. Noes 0. Page 1426.)Passed Assembly
- Vote recorded AB 787 Papan Assembly Third Reading. Result: pass.Lower
- Apr 24Read second time. Ordered to third reading.Minor
- Apr 23From committee: Do pass. (Ayes 15. Noes 0.) (April 23).Minor
- Vote recorded Do pass. Result: pass.Lower
- Apr 8Re-referred to Com. on APPR.Minor
- Apr 7Read second time and amended.Major
- Apr 3From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (April 1).Major
- Apr 1
- Vote recorded Do pass as amended and be re-referred to the Committee on [Appropriations]. Result: pass.Lower
- Mar 18Re-referred to Com. on HEALTH.Minor
- Mar 17From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.Major
- Mar 17Referred to Com. on HEALTH.Minor
- Feb 19From printer. May be heard in committee March 21.
- Feb 18Read first time. To print.Introduced